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Adelmidrol: a new ALIAmide for chronic inflammation

ADELMIDROL: a new topical ALIAmide for chronic inflammation

Adelmidrol is
the diethanolamide derivative of azelaic acid, i.e., naturally occurring
dicarboxylic acid that has long proven to be an effective topical treatment for
human inflammatory skin disorders (1), and whose mechanism of action have been
recently and thoroughly investigated (2).

Similarly to the anti-inflammatory
and anti-nociceptive compound palmitoylethanolamide (PEA) (3-17), adelmidrol
belongs to the aliamide family, a group of fatty acid derivatives with
cannabimimetic properties, able to control the event of mast cell (MC)
hyper-reactivity in several pathophysiological and pathological conditions (5).

adelmidrol: a synthetic ALIAmide

Adelmidrol is a synthetic compound with a symmetrical chemical structure. It is used extensively in Italy in veterinary medicine, to treat skin inflammation. In 2015 it was found the compound also excerts anti-inflammatory action given systemically in 10 mg per kg bodyweight.[1]

Adelmidrol in pet animals and in atopic eczema

Adelmidrol has been shown to negatively control the behavior of canine skin MCs during pathophysiological conditions (i.e. healing of experimental wounds). In particular, a statistically significant increase of intracytoplasmatic granular content of dermal MCs was shown in adelmidrol (2%)-treated wounds compared to control, thus suggesting the compound is effectively able to down-modulate skin MC degranulation in dogs (18).

Chronic gingiva inflammation can be a difficult to treat medical problem in dogs. A similar anti-inflammatory effect was observed in these dogs, treated with a gel to reduce gingival inflammation. Twenty dogs were randomised to the adelmidrol gel and placebo. After 30 and 45 days, the dogs using the adelmidrol gel had significantly less inflammation of the gingiva.

Furthermore, the local application of adelmidrol has been recently confirmed to reduce MC responses during chronic experimental inflammation, as shown by the significant decrease of mediators selectively expressed by MCs and involved in skin inflammation, such as chymase (19).

Adelmidrol seems well suitable for topical application, because exhibits both hydrophilic and lipophilic features, which help to absorb more effectively into the skin, epidermis being composed of alternating lipophilic and hydrophilic layers.

A 4-week topical treatment with adelmidrol 2% emulsion in children affected by mild atopic dermatitis resulted in complete resolution in 80% of cases, with no side effects and no relapses at 8-week follow up (20).